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The healthcare industry is global, and it’s a no-brainer that the United States has been welcoming foreign-educated nurses for years. However, as part of the visa requirements, international nurses are expected to demonstrate their English language proficiency by taking an English Language Test. With so many English language tests to choose from, it can be overwhelming to decide which one to take. This article provides a comparison of the most popular English language tests to help you choose the right one for your career aspirations. 

Differentiating PTE, OET, TOEFL, and IELTS English Tests  

To help you decide which of the popular English tests is best for you, here’s a comparison of the four English language tests acceptable for visa requirements

1. PTE (Pearson Test of English) Academic 

The PTE Academic Exam is a series of English language proficiency tests developed by Pearson, a multinational educational publishing and assessment company. It is a computer-based exam that can be taken at authorized test centers or online from anywhere in the world.  

Recognizing Nursing Bodies: The PTE test is recognized by several nursing bodies in the USA, including the National Council of State Boards of Nursing (NCSBN), the Commission on Graduates of Foreign Nursing Schools (CGFNS), and the International Council of Nurses (ICN). 

Eligibility criteria: To take the PTE test, you need to be at least 18 years of age with a valid passport. 

Test Duration: The exam lasts for 3 hours and consists of three parts including speaking and writing (54–67 minutes), reading (29–30 minutes), and Listening (30–43 minutes). 

States accepting PTE: The PTE test is accepted in all states in the USA. 

Grading system: The PTE test uses a scoring system that ranges from 10 to 90. This grading system is based on your performance in each section of the test, and the overall score is an average of the scores obtained in all sections. 

Score Results: PTE scores are typically available within 48 hours (about 2 days) of completing the test. However, in some cases, it may take up to five business days to receive the scores. 

2. OET (Occupational English Test) 

The OET is a healthcare-specific English language test that assesses the language proficiency of healthcare professionals. The test is widely recognized by nursing regulatory bodies in the United States, including the National Council of State Boards of Nursing (NCSBN) and the Commission on Graduates of Foreign Nursing Schools (CGFNS). It is considered by NCSBN and CGFNS to be an acceptable alternative to IELTS or TOEFL for non-native English speakers who wish to become licensed nurses in the US. 

Test Eligibility: To take the OTE, nursing professionals must meet specific requirements, including possessing a means of identification, registering with the OTE website, and paying the test fee. 

Test duration: The OTE test duration varies depending on the module being taken. For the nursing module, the test takes about three hours, comprising four sub-tests, including reading, writing, speaking, and listening. 

States accepting OTE: In the US, OTE is recognized by the nursing bodies in most states, including Arizona, Colorado, Idaho, Maine, Michigan, Montana, Nebraska, New Hampshire, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah, Vermont, Washington, and Wyoming. 

Grading system: The grading system for the OTE test is based on a scale of A to E. Each sub-test is graded separately, and a candidate must score at least a grade C in each sub-test to reach a minimum overall score of 300/500. 

Score Results: Test results are usually available within 16 business days. 

3. TOEFL (Test of English as a Foreign Language) 

The TOEFL exam evaluates the English proficiency of non-native speakers and is widely accepted by universities and colleges in the United States. TOEFL is accepted by more than 11,000 universities and institutions in over 150 countries. It is administered by the Educational Testing Service (ETS) and can be taken either online or at designated test centers around the world. 

Recognition by nursing bodies: The TOEFL is recognized by several nursing bodies, including the National Council of State Boards of Nursing (NCSBN), which administers the NCLEX exam for nursing licensure in the US. 

Test eligibility: While there are no specific age or educational qualifications required, you’ll need to provide a valid government-issued ID and have a basic understanding of the English language. 

Test duration: The exam takes around 4 hours to complete and consists of four sections including reading, listening, speaking, and writing. 

Grading system: TOEFL is scored on a scale of 0-120, with each section having 30 points.  

States that accept TOEFL: TOEFL is accepted by all states in the US, but the requirements may vary. Some states may require a minimum score of 90 on the TOEFL, while others may accept alternative tests or offer exemptions for certain candidates.  

Score Results: You can expect to see your result within 6-10 days of taking the test. These scores are valid for two years from the test date. 

4. IELTS (International English Language Testing System) 

IELTS, or the International English Language Testing System, is a standardized English test widely recognized by various nursing bodies including the National Council of State Boards of Nursing (NCSBN), the Commission on Graduates of Foreign Nursing Schools (CGFNS), and the Accreditation Commission for Education in Nursing (ACEN). 

Test eligibility: Like TOEFL and other English tests, you’ll need a valid government-issued ID and a basic understanding of the English language to take IELTS. 

Test duration: The IELTS test consists of four sections: Listening, Reading, Writing, and Speaking. The total test duration is 2 hours and 45 minutes. The listening, reading, and writing sections are conducted in a single sitting, while the speaking section may be taken on the same day or up to seven days before or after the other sections. 

Grading system: Each section of the IELTS test is graded on a scale of 0 to 9 bands, with band 9 being the highest possible score. The overall score is the average of the four section scores, rounded to the nearest half or whole band. 

States accepting IELTS:  IELTS is accepted in all states in the USA except Nevada, Kansas, Georgia, California, Maine, and Ohio. 
Score result: The IELTS test scores are typically available online on the 13th day after the test date for the paper-based test, and 3-5 days after the date for the internet-based test. This test score is valid and can be used within the space of two years from the test date. 

What’s the Best English Test for Filipino Nurses? 

When it comes to choosing the best English language test for Filipino nurses, there is no one-size-fits-all answer. However, the IELTS exam is a popular choice for Filipino nurses as it’s widely recognized and accepted by many healthcare regulatory bodies and nursing boards, including the National Council of State Boards of Nursing (NCSBN) in the US, the Nursing and Midwifery Council (NMC) in the United Kingdom, and the Nursing and Midwifery Board of Australia (NMBA). 

Many nursing schools in the Philippines offer IELTS preparation courses, making it a convenient and accessible option. When compared to other tests like OET, IELTS is more cost-effective. This makes it an ideal choice for candidates who may have limited financial resources. The test assesses relevant skills such as reading, writing, listening, and speaking skills of the test-taker, which are essential for effective communication in a healthcare environment. 

Ultimately, when choosing an English language test, you need to consider your career aspirations, the regulatory bodies you’re seeking registration with, and the state you plan on working in. Some states may have specific language requirements, and it’s crucial to check with the state board of nursing’s requirements before registering for an exam. 


At PRS Global, we’re devoted to your successful career here in America. From providing green Card sponsorship to reimbursements for NCLEX-RN, license endorsement application, IELTS, and VisaScreen. We’re here to ensure that you receive all the help you need to get onboarded as a nursing professional in the USA. 

Get your plans moving, contact us today